Health Care

Holly Lookabaugh-Deur, PT, DSc, GCSis the founder and president of Generation Care and contributes 34 years of clinical experience to the company with rehabilitation clinics across West Michigan. She specializes in post-mastectomy management, cancer-related fatigue, geriatric fall-prevention programming and hockey-related injuries. Holly is board certified as a geriatrics clinical specialist, a certified LSVT physical therapist, specializing in movement principles for lifelong management of Parkinson’s disease, a certified wound-care specialist and serves as a fall-prevention researcher for the Centers for Disease Control. She is also part of the adjunct faculty at CMU’s physical therapy doctoral program, a regular columnist for Senior Perspectives and has provided more than 20 continuing-education courses for her peers. Holly studied as an undergraduate at the University of Connecticut, obtained a master’s in health science neurology from GVSU and a doctorate of science in geriatrics from Rocky Mountain University.

The heart of health care reform: Part II

Customers sit in a waiting room, ready to be served. Photo via byu.edu

Editor’s note: This is the second post in a two-part take on the role of the consumer under Obamacare. The first post is here.

Wading through the impact of health care reform is no easy task, but one thing is clear: every player will play a part in making it work.

The consumer, the physician, the health care provider, the insurance company and the employer all play vital roles in piecing together a new culture of providing care for Americans.

Informed consumers

One challenge sure to complicate these changes is getting consumers engaged in the process of making informed choices in this new health care industry. So much of what has been televised, such as the health exchange and its early failures, can distract us from staying really informed. Even internet searches on related topics are top heavy with biased viewpoints, making the job of really learning the facts more difficult.

Remember this, taking care of our health is part of our life and responsibility. The more we relinquish these decisions to another party, the less control we will have. We need to know how much drugs cost and ask questions about why a total knee replacement costs $15,000 more at one hospital than the other.

Obamacare effects

Below are some real facts about Obamacare or the Patient Protection and Affordable Care Act, in no particular order of importance. This law asserts federal control over health care benefits and centralizes health care decisions in Washington.

In 2014, if you are uninsured, you will pay an annual tax of either 1% of your income or $95, whichever is larger, when you file taxes in 2015

In 2017, if you are uninsured, that tax grows to 2.5% of your income or $695, whichever is larger, when you file taxes in 2018

Doctors and hospitals will be reimbursed progressively on a fee for the outcome — a fixed amount to care for you — as opposed to the “old” way of fee for service

Insurance companies are no longer allowed to deny coverage, even with pre-existing medical co-morbidities or complex histories. This additional risk is reported to be one cause for the increase in the cost of insurance

The law cuts $716 billion from the Medicare program over the next 10 years. These “savings” do not go back into the Medicare program; they are slated to fund spending for provisions of the law

One-third of all seniors rely on Medicare Advantage, a private health coverage form of Medicare. Deep cuts in the Medicare Advantage program are mandated by the health care reform law

New taxes on drug manufacturers and medical device makers are included in the law. Costs for these taxes are currently reported to be passed to the consumer

Insurers are required to provide coverage for non-dependent children up to age 26

By a vote of 219 to 212, the House of Representatives passed the health care reform bill. No Republicans voted for the bill; 24 Democrats voted against the bill

Stick with the facts. Avoid the hype. Stay informed and advocate for your choice in all you do regarding your health — where you go, who you see and how you spend your health care dollars.

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